AB0308 FALL RISK EVALUATION WITH COMPUTERIZED DYNAMIC POSTUROGRAPHY IN RHEUMATOID ARTHRITIS PATIENTS
Authors: E. Baran, M. A. Dündar
Journal: Annals of the Rheumatic Diseases (2022)

Background Patients with rheumatoid arthritis (RA) have a higher risk of falling due to pain and physiological/biomechanical deformities (decreased muscle density, decreased functional stability, changes in gait, etc.) [1]. Although high incidences of falls have been reported in RA patients [1], there are not sufficient data regarding patient-specific fall risk. Objectives The aim of this study was to evaluate patient-specific fall risk, via computerized dynamic posturography, in RA patients, and to compare the results with those of age-matched healthy participants. Methods A total of 29 patients with RA (9 males, 20 females; mean age: 54.4±6.5 years) and 18 healthy participants (7 males, 11 females; mean age: 53.6±7.1) were included in the study. Detailed demographic, physical, and medical characteristics of the participants were recorded. Dynamic balance was tested with a computerized dynamic posturography, which assesses balance responses to induced postural disruption [2]. A translational ramp test (speed: 0.1 m/s), sinusoid tests (frequencies: 0.25 Hz - 0.50 Hz), and limits of stability evaluations were applied. Ramp and sinusoid tests were evaluated with the eyes open and closed, in the antero-posterior direction, and the participants were instructed to keep their balance during the tests. Limits of stability was evaluated on a static platform, with the eyes open. During the test, the participants were told to carry their pressure center as far as possible by performing the movement only from the ankle (in all directions), without lifting their feet, and trying not to fall. Results The groups were similar in terms of demographic and physical characteristics (p&gt;0.05). Patients with RA showed statistically significant dynamic balance alterations compared to healthy participants (p&lt;0.05) (Table 1). The fall test was positive in 31% of the RA patients and 5.6% of the control group (Figure 1). Table 1. Comparison of the groups in terms of the fall risk assessment criteria Test Parameters RA Group (n=29) Control Group (n=18) p 1.Ramp Eyes Open Energy in AP (J) 2051 (1071-2258) 1409 (1224-1644) 0.005* 1. Energy in ML (J) 213 (122-414) 208 (138-259) 0.369 1. Time in ML (s) 3.9 (3.0-4.4) 3.5 (2.6-3.9) 0.083 2.Ramp Eyes Closed Energy in AP (J) 1939 (1856-2147) 1718 (1334-1929) 0.024* 1. Energy in ML (J) 224 (174-364) 189 (155-381) 0.539 1. Time in ML (s) 3.9 (3.5-4.9) 3.4 (3.2-4.5) 0.007* 3.Sinusoid Gain in AP 1.1 (1.0-1.3) 1.1 (1.0-1.3) 0.809 Eyes closed Gain in ML 0.3 (0.3-0.4) 0.2 (0.2-0.3) &lt;0.001* Eyes open Gain in AP 1.0 (0.8-1.3) 0.7 (0.6-0.8) 0.003* 4.Limits of Stability Surface (cm 2 ) 13.0 (10.0-15.0) 21 (17.7-21.5) &lt;0.001* Data are presented as median and interquartile range. p value; Mann Whitney U Significance Test results between groups. (*): statistically significant difference (p&lt;0.05). AP: Antero-posterior, ML: Medio-lateral Figure 1. Distribution of participants according to the number of positive criteria. The fallers met at least three criteria. Conclusion The results of this study showed that dynamic postural responses to destabilizing conditions are significantly altered in patients with RA compared to healthy controls. Determining the patient-specific fall risk is important in designing personalized rehabilitation programs and reducing the risk of injury. References [1]Armstrong C, Swarbrick CM, Pye SR, O’Neill TW. Occurrence and risk factors for falls in rheumatoid arthritis. Ann Rheum Dis. 2005;64(11):1602-4. [2]Ghulyan V, Paolino M. Posturography for evaluating risk of falls in elderly unstable patients. Fr ORL. 2005;88:97-103. Disclosure of Interests None declared